title: Patients whose physicians recommend colonoscopy and those who follow through.
abstract: BACKGROUND
  More than half of eligible individuals are not up-to-date with colon cancer screening.
  
  
  OBJECTIVE
  To assess the characteristics of those who received a colonoscopy screening recommendation and those who followed the physician recommendation.
  
  
  METHODS
  Patient self-administered questionnaire and medical record review in 16 private family physician practices.
  
  
  RESULTS
  From 8372 patients invited to participate, 685 were enrolled and had a medical record review; 219 (32%) had a colonoscopy recommendation and 86 (39%) received a colonoscopy. Independent factors associated with having a recommendation for colonoscopy were significantly younger in age (odds ratios [OR] = 1.6), higher incomes (annual income ≥$40 000 vs <$40 000; OR = 1.8), physician or nurse discussion about colon cancer tests (OR = 1.6), physical visit in the preceding 26 months (OR = 1.7), distant relative with colon cancer (OR = 2.4), and a medical diagnosis of hyperlipidemia (OR = 2.1). Independent factors associated with following through on colonoscopy after a recommendation were age ≥65 years (OR = 0.3), male patient (OR = 0.4), and feeling that colon cancer screening is very important (OR = 3.2).
  
  
  CONCLUSIONS
  Socioeconomic factors are associated with receipt of a colonoscopy recommendation. Fewer than one third of patients had documentation of a physician colonoscopy recommendation and of those, less than half followed through.
authors.affiliation: Department of Family Medicine, University of Iowa, Iowa City, IA 52242, USA. jeanette-daly@uiowa.edu
authors.forename: Jeanette M
authors.initials: JM
authors.lastname: Daly
authors.forename: Yinghui
authors.initials: Y
authors.lastname: Xu
authors.forename: Barcey T
authors.initials: BT
authors.lastname: Levy
mesh_terms: D017677:Age Distribution; D000368:Aged; D003113:Colonoscopy / Q000523:psychology* / Q000706:statistics & numerical data; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000517:prevention & control*; D055088:Early Detection of Cancer / Q000523:psychology* / Q000706:statistics & numerical data; D005192:Family Health; D005194:Family Practice / Q000379:methods / Q000592:standards*; D005260:Female; D006801:Humans; D007484:Iowa; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology* / Q000706:statistics & numerical data; D010865:Pilot Projects; D011369:Professional-Patient Relations; D016032:Randomized Controlled Trials as Topic; D017010:Reminder Systems; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires
keywords: colonoscopy; colorectal cancer; colorectal cancer screening; practice-based research network